Me and My Physical Therapist (Blog #649)

Thirteen days ago I had knee surgery to repair my ACL in my left knee, and this morning I saw my surgeon to follow up about it. First, his nurse removed my (17) staples. Then he showed me pictures from the surgery (two of which I’ll share momentarily) and said it went well. In terms of my progress, he seemed impressed, especially with the facts that I’m off crutches, out of a brace, and bending my knee more than 90 degrees. “If I were being picky, I’d say you need to straighten your leg more, but it’s not bad,” he said.

Ever the perfectionist, I now have a new goal.

The surgeon said I should see continual progress for the first two or three months. “That’ll be exciting and keep you motivated,” he said. “But then you’ll forget anything was ever wrong, and whereas I want you to forget at some point, I don’t want you to forget before six months and do something stupid like jump a ditch.” Then he explained that six months is how long it takes to get blood flowing to the newly constructed ACL, which is why I have to be ever-so-gentle with it until then. That means no swimming, jumping, or planting and turning (as in spinning, pivoting, or–um–dancing).

Here’s a picture of my old ACL. It looks sad, frayed, and lifeless because I completely tore it away from the bone. Personally, it reminds me of sushi.

Here’s a picture of my new ACL, which the surgeon constructed from my patellar tendon. Talk about pretty. (Don’t be jealous; I’m sure yours looks nice too.) Note that tendons are stronger than ligaments, which is why some surgeons (mine included) prefer to reconstruct the ACL (a ligament) using the patellar tendon (a tendon, duh) rather than a hamstring (another ligament).

After leaving the surgeon’s office and killing time at a coffee shop reading a book, sipping tea, and propping my foot up on a chair (in order to straighten my leg), I had my first official physical therapy appointment. And whereas I was nervous about whether or not I’d jive with the guy, all my fears were immediately laid to rest. He’s awesome. Not only has he been at this for twenty years, but he’s also worked with my surgeon for a long time, and they’re on the same page in terms of objectives and timelines. Plus, he spent a lot of time today really explaining what happened both when I injured myself and during surgery.

“Your ACL is nothing but a tie-down,” he said. “If you had a bicycle with two straps holding it on the back of a trailer, and you cut one strap, the bike would fall over. It’s the same with your knee cap.” Which explains why things felt loose immediately after my injury. My PT (physical therapist) said he’s known people who have lived decades without their ACL, but they end up literally rubbing their bones together, and that causes a lot of problems later in life. “The whole point of the surgery you had is to get you back to doing what you were doing before without additional issues down the line,” he said.

The physical therapy itself wasn’t too complicated. Granted, it was more than I’ve been doing at home, but it wasn’t painful or grit-your-teeth awful. A few stretches, some mini-squats, some leg lifts, some stair-climbing. Then my guy hooked me up to a STEM machine, a device that uses electrical impulses to make your muscles (my quad muscles) twitch and fire. At the same time, he wrapped my knee in another device that was basically a giant leg condom filled with cold water (pumped in by a machine through an attached hose) to reduce swelling. I didn’t take any pictures of this, but here’s a picture of my swollen and bruised leg from this morning. No wonder my ankle’s been hurting.

My PT also explained why my leg has felt achy–because the surgeon used a drill bit as long as my forearm to tunnel through my leg bones. “Oh, that explains it,” I said. Then my PT showed me an animated (not real) video of how the surgery actually went down. Y’all, it’s totally crazy. He took the middle third of my patellar (kneecap) tendon out, along with two pieces of bone attached to it (one at either end; supposedly the holes from which the bones were taken will fill in over time). Then he sewed up the outer two-thirds of my patellar tendon and used that big drill bit to tunnel through my leg on a diagonal. (The ACL and its tie-down buddy, the PCL, criss-cross through the knee–I think.) Then he fished the new ACL through the tunnel and attached the bone pieces to other bones with screws. “That thing ain’t going nowhere,” both my surgeon and my PT said.

Is that wild or what? And seriously, no wonder recovery is a long process. I’ve been cut up and put back together. Along the way, I’ve gained an inch in circumference around my kneecap (from swelling) and lost an inch in circumference around my thigh (from muscle atrophy). “How long will it take to get those muscles built back up?” you might ask. A year. A full year because muscles are made from slow-twitch fibers and fast-twitch fibers, and I can’t use my fast-twitch fibers until six months post-surgery (since they’re the ones used for jumping, sprinting, etc., and that stuff, as already explained, is off-limits). And whereas a week ago this slow recovery process disheartened me, today I’m okay with it, I’m assuming because I have more information than I did before, because I actually understand both what’s happened and what’s happening.

Never underestimate the power of information.

Now if you’ll excuse me, I’m sure there’s a rehab exercise I need to be doing.

Quotes from CoCo (Marcus)

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Who’s to say that one experience is better than another?

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A Day for Hoping (Blog #624)

It’s 8:30 on a Friday night, and I’ve been doing laundry for the last three hours and eating peanut butter by the spoonful. I know–I live a sexy life. (Try not to be jealous.) During my second load of laundry (of three), a pair of athletic shorts I’ve had since Jesus was a small boy got “hung up” in the dryer. I guess the drawstring snagged on the lint catcher. When I pulled the shorts out, the string was wound up tighter than a spring. Alas, the string was beyond repair, since it was sewn into the shorts and there was no way I could re-thread it. So grabbing a pair of scissors, I snipped the string and removed it altogether.

All good things must come to an end.

This morning, at the direction of my primary care physician, I saw an orthopedic surgeon who specializes in knees and sports injuries. This ended up being the best thing, and I consider it “an act of the universe” because I only called to make the appointment yesterday. Having looked at my MRI, the surgeon explained that as a result of my accident two weeks ago, I’d 1) bruised a bone, which was no deal at all, 2) torn my lateral meniscus, which was a small deal, and 3) severed my ACL, which was a big deal. He went on to say that the meniscus acts as a shock absorber and is basically a backup system for your joints. “They help stave off arthritis,” he said, “and I tell people that if you make it to 40 with yours intact, you’ve gotten your money’s worth. You’re 38, so close enough.” Then he said that because your ACL runs THROUGH your kneecap and gets a limited supply of blood, it CAN’T repair or heal itself when badly damaged.

“Yours is dying as we speak,” he said.

So that felt good.

The surgeon proposed shaving off the damaged part of my meniscus (since sewing a meniscus back together doesn’t work) and reconstructing my ACL with part of my own patellar tendon (the tendon just below one’s kneecap). He said, “If we used a cadaver’s, you’d heal faster, but your own will function slightly better. Since you’re an active person and I want you as strong as possible, I’d suggest using your own.” And then–get this shit. For the last thirteen days I’ve been hopping around on one leg, using crutches, using a walker. But like some sort of FAITH HEALER, this guy today said, “Stop using your crutches. Stop using your brace. I want you WALKING before surgery.”

Remembering how my leg gave out while I was performing two weeks, I sat there in disbelief.

The surgeon went on to explain that “you don’t need your ACL to walk,” since it’s responsible for twisting and pivoting movements, but other muscles, ligaments, and tendons are responsible for everyday getting around. Then he talked me through straightening my leg out fully and bending it to at least ninety degrees. Y’all, I almost fainted the pain was so awful. But the surgeon said, “If you think a loose knee is bad, you should try a stiff one.” (I thought, I’d rather try a stiff drink.) Still, his point was that I’ve gotta get my leg moving through its normal range of motion both before and after surgery so that my knee doesn’t “lock down.” Plus, he said movement would help reduce swelling, which I have plenty of.

So we have a plan. Surgery is scheduled for December 26. (Merry Christmas, Marcus Coker.) If you’d like, send cards, flowers, chocolates, and handsome, eligible bachelors to me by way of my parents.

Believe it or not, after all this time of my being fearful of putting weight on my left leg, I walked out of the surgeon’s office and have been walking the rest of the day. Sure, it’s not overly graceful walking–I’m not ready for the runway–but this is huge progress. Hell, I’ve even been walking up and down stairs. And whereas I can sometimes feel my knee strain, the surgeon said, “Don’t worry. You won’t do any damage. It’s ALREADY TORN.”

So that was a nice reminder.

Here’s a picture of the brace I no longer have to wear. Notice the cat (Oscar) peeking over the kitchen island.

Considering the fact that I haven’t fallen down yet, I’m thrilled about being able to walk. Honestly, I’ve been more optimistic today than I have been in the last two weeks. Like, life doesn’t completely suck. What does suck, I’ll admit, are these stretching exercises. Straightening my leg isn’t so bad, but bending it hurts like hell. I get nauseated every time I go past a certain point. Still, I’m determined to slowly make progress, since we’re talking about my potential for future movement here. To that end, I’m also not letting myself “cheat” on the stairs, as in only using my good leg to push myself up. Rather, I’m doing things like I normally would.

Push with my right leg, push with my left leg (say a curse word).
Push with my right leg, push with my left leg (say a curse word).

Even with limited range of motion and trepidation in my steps, having both my legs back is a game changer. Part of me wishes I’d known to “take up thy bed and walk” sooner, but this way I have a greater appreciation for all the “simple” things I took for granted before. Things like being able to get up and get myself a glass of water, do my own laundry, or even take a shower without sitting down or having to tie the handheld sprayer to an overhead mirror with the strap of a fluffy scubby thingy. (See picture below.)

Today is a day for hoping.

The way I’m thinking about my severing my ACL is the way I’m thinking about my cutting the drawstring in my athletic shorts this evening. All good things must come to an end. (It was nice knowing you.) This moment is my new normal. And whereas part of me is fearful (I’ve been afraid to put weight on my leg for the last two weeks), another part is hopeful. Even confident. While driving home from the surgeon’s office, it was weird, it was like I could hear my leg talking to me. Not out loud of course, but our bodies are alive and our cells are conscious, so why couldn’t they talk to us? Anyway, I felt like mine was saying, “We can do this. We can support you.” This is huge, the idea that my body and I are working together here, that we’re stronger than I previously believed, and that our future looks bright.

Yes, today is a day for hoping.

Quotes from CoCo (Marcus)

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The clearer you see what's going on inside of you, the clearer you see what's going on outside of you. It's that simple.

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